Instructions on How to file a claim under the EEOICPA

Filing a Claim

The Division of Energy Employees Occupational Illness Compensation (DEEOIC) has made a variety of forms available on-line. These forms may be completed and submitted to DEEOIC using the “Print Form and Mail Option.”

A link to the DEEOIC forms is listed below. The forms are only available in PDF format. In order to view and/or print PDF documents you must have a PDF viewer (for example, the free Adobe Acrobat Reader) available on your workstation. Also, when printing these forms please remember to use the Adobe Acrobat Reader PRINT icon at or near the top of the form and not your browser's print icon.

Print Form and Mail Option

The DEEOIC forms link can be accessed below. Print and submit forms via U.S. MAIL. Simply click on the appropriate form to begin. Then fill in the required information using your computer keyboard and print the form using the Adobe Acrobat Reader PRINT icon. You may hand write any additional information on the printed hard copy. You may decline the option to apply for a digital signature and instead sign the form with your hand-written signature. Finally, you can mail the completed form to:

The Resource Centers can assist claimants in completing the necessary forms, provide valuable information about the claims process to claimants, and transmit documents to the DEEOIC District Offices. The Resource Centers can provide assistance either in person or over the telephone, and thus are able to service individuals who are outside the immediate geographical area. The resource centers also conduct outreach activities to inform the public of benefits and requirements of the EEOICPA.

The complete list of Resource Centers, including regional jurisdiction and contact information, and toll-free numbers can be found at the DEEOIC website.